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Upper Leg Muscles Cheat Sheet (DRAFT) by

Upper leg muscles - Hamstrings, Adductors, Abductors, Quads

This is a draft cheat sheet. It is a work in progress and is not finished yet.


Consists of:
- Bicep Femoris
- Semime­mbr­anosus

Bicep Femoris

Origin: Long head: infero­medial upper area of the ischial tuberosity and sacrot­uberous ligament
Short head: lateral lip of linea aspera
Insertion: Head of the fibula
NS: Long head: Tibial nerve Short head: Common fibular nerve
Action: Flexes know joint, laterally rotates knee joint when knee is flexed, long head extends hip joint


Origin: Ischial Tuberosity
Insertion: Medial condyle of femur
NS: Tibial part of sciatic nerve (L5 -S2)
Actions: Extends hip and flexes knee


Origin: Tuberosity of the ischium
Insertion: Per anserinus
NS: Sciatic (tibial L5-S2)
Action: Flexion of knee, extension of the hip joint

Hamstring TrPs


Origin: ASIS
Insertion: Antero­medial surface of the proximal tibia (pes anserinus)
NS: Femoral nerve L2-L3
Action: Flexion, Abduction and lateral rotation of the hip and flexion of the knee

Sartorius - Palpation

Sartorius TrPs

- Usually superf­icial sharp/­tin­gling pain
- Rarely seen alone as a myofascial pain producer
- Sleepi­ng/­lying with hips and knees flexed can cause TrPs in this muscle
- Active during seated cycling
- Consider this muscle in patients with meralgia paraes­thetica along with quads and iliacus

Tensor Fascia Lata (TFL)

Origin: ASIS
Insertion: Iliotibial tract
NS: Superior Gluteal nerve (L4-S1)
Action: Hip - Flexion, medial rotation, abduction Knee- Lateral rotation Torso - Stabil­isation

TFL and ITB palpation


- Can be misdia­gnosed as tronch­anteric bursitis
- Runnin­g/w­alking on sloped surfaces increase risk of TrPs
- Tightness of TFL can lead to a short leg when prone/­supine
- TrPs in anterior glut mini can lead to TrPs in TFL
- Tight QL, TFL overpower weak/i­nhi­bited Glut med - leads to lumbar lordosis - deal with tight muscles first before streng­thening glut med


Consists of:
- Rectus Femoris
- Vastus Interm­edius
- Vastus Lateralis
- Vastus medialis

Rectus Femoris

Origin: AIIS and bony ridge
Insertion: Patellar tendon
NS: Femoral nerve L2-L4
Action: Knee extension, Hip flexion

Rectus Femoris TrPs

- Felt deep in knee joint
- Wakes pt up at night - pain infront of patella and lower anterior thigh
- Knee pain + sense of weakness going down stairs
- Can diminishe the L4 reflex
- Secondary TrPs in other quad muscles and iliopsoas major

Vastus Interm­edius

Origin: Anteri­ola­teral femur
Insertion: Patella tendon
NS: Femoral nerve L2-L4
Action: Extension of the knee
Articulus genu - small muscle , usually blends in VI, thought to retract synovial suprap­atellar bursa proximal during extension

Vastus Interm­edius TrPs

- TrPs cause difficulty straig­htening the knee
- Buckling knee can be TrPs in vastus interm­edius and 2 heads of gastro­cnemius

Vastus Lateralis

The largest of the quads
Origin: GT, intert­roc­han­teric line and linea aspera of the femur
Insertion: Patella tendon
NS: Femoral nerve L2-L4
Action: Extends and stabilise knee

Vastus Lateralis TrP

- Lying on affected side can disturb sleep
- TrP can cause stuck patella syndrome (patella loses all passive movement - stiff leg and dragging foot)
- Anterior fibres of Glut mini can cause satellite Trps in VL

Vastus Medialis

Origin: Medial side of femur
Insertion: Quads tendon
NS: Femoral Nerve L2-L4
Action: Extends knee

Vastus Medialis TrP

- Produce toothache like pain deep in the knee joint that interrupts sleep, pain fades over weeks and then buckling and weakness occurs
- Excessive pronation of the foot and Morton's foot can lead to TrPs in this muscle


Location of the Pectineus (black)
Origin: Pectineal line of the pubic bone
Insertion: Pectineal line of the femur
NS: Femoral Nerve L2-L3 and accessory obturator L3
Action: Adduction and flexion of the thigh

Pectineus - Palpation

- Hip slightly flexed and lateral rotated
- Pt adducts hip slightly
- Slide off adductor tendon laterally

Pectineus TrP

- Should be checked for TrPs after treating ilipsoas and adductor TrPs

Adductor Brevis

Origin: Anterior surface of inferior Ramus and body of the pubis
Insertion: Lesser tronch­anter and linea aspera
NS: Obturator nerve L2-L3
Action: Adducts thigh, controls leg swing through gait cycle and postural control

Adductor Brevis TrPs

Adductor Longus

Origin: Pubic body, below pubic crest
Insertion: Middle 1/3 of linea aspera
NS: Anterior branch obturator nerve L2-L4
Action: Adduction of hip, flexion of hip joint

Adductor Longus TrPs

Same as Adductor Brevis
- Common cause of groin pain
- Adductor longus bilateral TrPs can occur in horse riders - check for lumbar lesions

Adductor Magnus

Origin: Pubis, tuberosity of ischium
Insertion: Linea Aspera and adductor tubercle of femur
NS: Posterior branch of obturator nerve and sciatic nerve (L2-L4)
Action: Both portions adduct hip, hip flexion (adductor portion) , Ext hip (Hamstring portion)

Adductor magnus TrPs

- TrP below pubic bone can refer pain into rectum, pubic bone, vagina or bladder - pain is sharp and shooting
- Adductor Magnus active when climbing stairs, inactive when descending


Origin: Ischio­pubic Ramus
Insertion: Tibia (pes anserinus)
NS: Anterior branch of obturator nerve L2-L3
Action: Flexes, medially rotates and adducts hip

Gracillis TrPs

- Can be hot/st­inging pain that travels along inside of thigh